With a focus on improving infection-related perinatal morbidity and mortality, 5 years ago, the University of Alabama at Birmingham (DAB) and the Aga Khan University (AKU), in Karachi, Pakistan competed for and were awarded a Research Unit within the Global Network (GN). Despite several setbacks, the UAB/AKU Collaboration has evolved into a very well-functioning and highly productive research and training program. This renewal application seeks to maintain and enhance that Global Network Research Unit (GNRU) focusing on improving developing country maternal-infant health with a specific emphasis on reducing perinatal morbidity and mortality. This GNRU will be, as before, a partnership between The Dept of OBGYN at UAB and the Dept of Community Health Sciences at AKU. The clinical subjects for studies conducted in Pakistan will include pregnant women from both urban and rural, and hospital and community-based populations. Through this study and our participation in other common protocols, we hope to stimulate the development and growth of Pakistani researchers and promote collaborations between AKU researchers and those from UAB. We also intend to attract new U.S. and Pakistani investigators to the field of international Maternal and Child Health research by systematic mentoring of promising junior investigators and recruiting senior scientists from related fields. In doing all this, we hope to enhance the research environment available to AKU scientists by providing high quality responsive administrative, statistical and research support services within a scientifically stimulating multidisciplinary setting. With the completion of these multi-centered projects, not only will we have answered some very important questions related to pregnancy and newborn outcomes in developing countries, but AKU, in partnership with UAB, will have developed a superb rural and urban perinatal-related research infrastructure, tightly linked to their developing maternal and child health care systems.